• Title/Summary/Keyword: Peripheral Neuropathies

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Charcot-Marie-Tooth Disease Type 1A Diagnosed Based on Abnormalities in a Nerve Conduction Study in a Patient with Myotonic Dystrophy Type 1: A Case Report (신경전도검사의 이상소견을 보이는 근긴장디스트로피 환자에서 진단된 1형 샤르코-마리-투스 병: 증례보고)

  • Lee, Hyung Nam;Won, Yu Hui
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.148-152
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    • 2018
  • Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disorder and one of the most common muscular dystrophies affecting adults. Charcot-Marie-Tooth (CMT) disease, a common hereditary neuropathy, is characterized by atrophy of the distal limbs and peripheral nerve abnormalities. The authors report a rare case involving a 24-year-old female who was diagnosed simultaneously with both DM1 and CMT1A based on the results of a nerve conduction study (NCS). The patient, who had previously been diagnosed with DM1, was admitted for lower extremity pain. Her electrodiagnostic examination continued to reveal severe sensorimotor demyelinating polyneuropathy, and a genetic study was performed to confirm whether she had other hereditary neuropathies, except DM1, that suggested CMT1A, the most common phenotype of CMT. Severe abnormalities in an NCS in a DM1 patient may suggest the incidental coexistence of hereditary neuropathies, and further evaluations, such as genetic studies, should be performed for proper diagnosis.

The Effects of Foot Reflexology on Peripheral Neuropathy, Symptom Distress, Anxiety and Depression in Cancer Patients Treated with Oxaliplatin (발반사요법이 항암화학요법 관련 말초신경병증, 증상 디스트레스, 불안 및 우울에 미치는 효과)

  • Lee, Se Young;Ham, Yun Hee;Ok, Oh Nam;Kim, Eun Ji;Kwon, In Gak;Hwang, Moon Sook;Cho, Myung Sook
    • Asian Oncology Nursing
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    • v.12 no.4
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    • pp.305-313
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    • 2012
  • Purpose: This study was done to clarify the effects of foot reflexology on peripheral neuropathy, symptom distress, anxiety and depression in cancer patients treated with oxaliplatin. Methods: A quasi-experimental design was employed. Changes in the variables were evaluated to test the effects of foot reflexology. Participants were cancer patients treated with oxaliplatin (experimental group 14 and control group 17). Peripheral neuropathy, symptom distress, anxiety and depression were measured before and after reflexology. Data were collected from October, 2010 to April, 2011. ${\chi}^2$-test, Fisher's exact test, t-test, Wilcoxon signed rank test and the Mann-Whitney U test were used to analyze the data. Results: The experimental group who received foot reflexology experienced less peripheral neuropathy and symptom distress than the control group. There was no difference in anxiety and depression between the experimental and control group. Conclusion: The foot reflexology program adopted in this study was found to be an effective method to reduce peripheral neuropathy and symptom distress. We recommend foot reflexology for patients with chemotherapy induced peripheral neuropathy.

Relationship between Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Patients with Hematologic Malignancies

  • Song, Chi Eun;Kim, Hye Young;Lee, Eun Sook
    • Korean Journal of Adult Nursing
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    • v.27 no.3
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    • pp.358-366
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    • 2015
  • Purpose: This study was aimed to identify the incidence and severity of chemotherapy-induced peripheral neuropathy (CIPN) among patients with hematologic malignancies and to examine the relationship between the quality of life (QOL) and CIPN. Methods: A total of 66 patients with CIPN-related symptoms participated in this study. Data were collected through self-reported questionnaires consisted of the European Organization for Research and Treatment of Cancer QLQ-C30 version 3.0 and the 16-item QLQ-CIPN20. Data were analyzed with SPSS/WIN20 for descriptive statistics using the Mann-Whitney and Kruskal-Wallis tests, and Spearman's rho. Results: The mean lower and upper extremity scale scores were 31.95 and 23.16 respectively for the 16-item QLQ-CIPN20. The mean QLQ-C30 subcategory scores were 46.84 for global health status, 58.72 for functional scales, and 34.85 for symptom scales. The CIPN-related lower extremity scale symptoms correlated negatively with the QOL subscales. There was no correlation between CIPN-related upper extremity symptoms and health-related QOL. Conclusion: Patients with hematologic malignancies treated with neurotoxic chemotherapeutic agents had CIPN-related symptoms in the lower extremities mainly, and their QOL functional subscale scores were relatively lower than those of other cancer patients. Interventions need to be developed for patients with hematologic malignancies to alleviate CIPN and enhance their QOL.

Peripheral Neuropathy in the Orofacial Region after Third Molar Extraction as an Initial Manifestation of Anemia: Two Case Reports

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.44 no.1
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    • pp.40-44
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    • 2019
  • Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.

Reliability and Validity of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire to Assess Chemotherapy-induced Peripheral Neuropathy

  • Kim, Hye Young;Kang, Jeong Hee;Youn, Hyun Jo;So, Hyang Sook;Song, Chi Eun;Chae, Seo Young;Jung, Sung Hoo;Kim, Sung Reul;Kim, Ji Young
    • Journal of Korean Academy of Nursing
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    • v.44 no.6
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    • pp.735-742
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    • 2014
  • Purpose: This study was performed to assess the reliability and validity of the Korean version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-induced peripheral neuropathy 20 items (EORTC QLQ-CIPN20) in patients receiving neurotoxic chemotherapy. Methods: A convenience sample of 249 Korean cancer patients, previously or currently, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. Collected data were analyzed using SPSS 21.0 and AMOS 21.0. Construct validity, known-group validity, concurrent validity, and internal consistency reliability of the Korean version of the QLQ-CIPN20 were evaluated. Results: Factor analysis confirmed 3 dimensions of CIPN: sensory, motor, and autonomic. The factor loadings of the 20 items on the 3 subscales ranged from .38 to .85. The 3 subscale-model was validated by confirmatory factor analysis (GFI=.90, AGFI=.86, RMSR=.05, NFI=.87, and CFI=.94), and concurrent validity was demonstrated with the EORTC QLQ-C30. Furthermore, the QLQ-CIPN20 established known-group validity. The Cronbach's alpha coefficients for internal consistency of the subscales ranged from .73 to .89. Conclusion: The Korean version of the EORTC QLQ-CIPN20 showed satisfactory construct, concurrent, and known-group validity, as well as internal reliability.

Acute Motor Axonal Neuropathy Combined with Acute Disseminated Encephalomyelitis (급성 파종성 뇌척수염에 동반된 급성 운동 축삭형 신경병증)

  • Yu, Seong-Yong;Lim, Eui-Seong;Shin, Byoung-Soo;Seo, Man-Wook;Kim, Young-Hyun
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.52-56
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    • 2004
  • Acute motor axonal neuropathy (AMAN) is a subtype of Guillain-Barre syndrome and characterized by selective involvement of motor fibers. Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of central nervous system. The coincidence of central and peripheral nervous system involvement has been reported rarely. We described a 37-year-old male patient presented with fever and altered consciousness. The examination of cerebrospinal fluid and brain magnetic resonance imaging was compatible with acute disseminated encephalomyelitis. Several days after admissionb his mentality was improved but quadriparesis, multiple cranial neuropathies, and areflexia were detected. Electrophysiologic studies suggested axonal form of motor dominant polyneuropathy. We report a case of acute motor axonal neuropathy combined with ADEM. We consider that this case is an example of simultaneous immunologic process to the common pathogenic epitope of central nervous system and peripheral nervous system.

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Experience with Spinal Cord Stimulation for Relief of Causalgia on the Right Lower Extremity -A case report- (척수신경 자극기를 이용한 우하지 작열통의 치험 -증례 보고-)

  • Lee, Dong-Ki;Kim, Yong-Ik;Park, Wook
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.229-231
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    • 1996
  • Spinal cord stimulation(SCS) was first attempted to relieve intractable pain in 1966. SCS has evolved into percutaneously implanted electrode with aim of activating spinal pain-inhibiting mechanism via dorsal columns. SCS is valuable for the treatment of many painful and difficult to treat conditions such as postamputation pain, painful peripheral neuropathies, chronic sciatic pain and so on. We treated a case of causalgia of the right lower extremity with successful outcome of 90% sustained relief of pain. And patient has satisfied using SCS(Model MNR-94, Neuromed) for 6 months follow-up.

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Multiple Cranial Neuropathy with and Polyradiculoneuropathy as a Delayed Sequelae after of Ethylene Glycol Intoxication (에틸린 글리콜 중독 이후 나타난 지연성 다발성 뇌신경병 및 다발신경뿌리신경병)

  • Kim, Min-Soo;Kim, Sun-Young;Kwon, Jee-Hyun;Kim, Wook-Joo;Jung, Hyun-Chul
    • Annals of Clinical Neurophysiology
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    • v.15 no.2
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    • pp.63-67
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    • 2013
  • Multiple cranial and peripheral neuropathies as a delayed sequellae of ethylene glycol poisoning is a less well known clinical entity and its information about long-term electrophysiological and clinical outcomes is limited. We report a 45-year-old male who presented with acute renal failure and subsequently developed multiple cranial neuropathy, respiratory failure, and flaccid tetraparesis. Through sequential electrophysiological studies, we would like suggest that the main pathophysiology of ethylene glycol-related neuropathy is a demyelinating polyradiculoneuropathy with secondary axonal degeneration.

Neuropathic cancer pain: prevalence, pathophysiology, and management

  • Yoon, So Young;Oh, Jeeyoung
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1058-1069
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    • 2018
  • Neuropathic cancer pain (NCP) is caused by nerve damage attributable to the cancer per se, and/or treatments including chemotherapy, radiotherapy, and surgery; the prevalence is reported to be as high as 40%. The etiologies of NCP include direct nerve invasion or nerve compression by the cancer, neural toxicity, chemotherapy, and radiotherapy. NCP is subdivided into plexopathy, radiculopathy, and peripheral neuropathies, among several other categories. The clinical characteristics of NCP differ from those of nociceptive pain in terms of both the hypersensitivity symptoms (burning, tingling, and an electrical sensation) and the hyposensitivity symptoms (numbness and muscle weakness). Recovery requires several months to years, even after recovery from injury. Management is complex; NCP does not usually respond to opioids, although treatments may feature both opioids and adjuvant drugs including antidepressants, anticonvulsants, and anti-arrhythmic agents, all of which improve the quality-of-life. This review addresses the pathophysiology, clinical characteristics and management of NCP, and factors rendering pain control difficult.

Diagnosis of Ulnar Neuropathy Caused by Intraneural Ganglion at Elbow with Ultrasound (신경내 결절종과 연관된 척골 신경병증의 초음파 진단)

  • Kang, Inhyun;Bae, Minjoon;Hur, Yangrok;Hwang, Kihun
    • Clinical Pain
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    • v.19 no.2
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    • pp.97-100
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    • 2020
  • An intraneural ganglion in the peripheral nerve and the resulting ulnar neuropathy at the elbow are uncommon and may show various symptoms ranging from local pain to motor and sensory impairment. We report a case of a 76-year-old man who was diagnosed with ulnar neuropathy caused by an intraneural ganglion derived from the elbow. We also discuss the pathophysiology, treatment, prognosis, and diagnostic value of ultrasonography in neuropathy caused by a ganglion.